The present invention relates to a method and a device for identifying an operation site to be treated, in particular an eye, in laser operations.
In laser operations, in particular of an eye, data allowing individual treatment of an eye is required for controlling the laser. This data is usually acquired or determined as patient data; methods such as eyesight testing, refractometer, measuring the topography, for example, of the cornea or of the lens, as well as the aberration of the eye being used for this purpose. This data is stored, whether in a computer-aided manner or manually in a file. Such data includes name, sphere, cylinder, axis, eye (left/right), topography, aberration, etc.
In a later step, this data is entered (sphere, cylinder, axis) or the shot coordinates for the surgical laser are loaded, which were obtained from calculations of topography-aided data or the derivation of coordinates from measurement of the aberrations of the eye. After that, the laser operation is performed based on the data entered.
Thus, the data acquisition and the use of these data sets are separated in space and time. The association between the data and the patient or the individual eye is accomplished using the patient's personal data such as name, first name, date of birth, etc.
Due to the separation in space and time between the acquisition of the data and its use for a laser operation, a connection between the patient's eye at which the data was obtained and the patient's eye on which the operation is to be performed is only given by way of aids. These aids are predominantly the patient's name, the ID number of the physicians' practices, and information on the eye (left or right) from which the data was obtained.
Therefore, this can result in an incorrect association between the data set of the correction and the specific eye under operation. This may be due to the system software used for maintaining the data sets, or else to human failure. In particular, the right and left eyes of the same patient can easily be confused, even when acting in the most careful manner during data acquisition. Confusion of patients with each other (similarity of names, inattentiveness during data acquisition, etc.) is also possible.
An object of the present invention is to provide a method and a device for identifying an operation site, in particular an eye, during a laser operation, which prevent the risk of operations of the wrong operation site or eye.
The present invention provides a method for identifying an operation site during an operation, in particular using a laser system, with the help of unique data about the operation site, a first copy of the unique data being stored in the laser system, the unique data being located in the immediate vicinity of the operation site and/or at the operation site, the first copy and the unique data being checked for their identity before the operation begins, and the result of the identity check being passed on to the laser system. This enables the individual operation site, mainly the eye, to be uniquely identified as the correct one for which the shot positions are provided in the laser. In this way, it is prevented that a patient is treated with incorrect shot data and, thus, that corrections, for example, of his/her eye are made that were calculated for a different patient.
Laser systems are understood to mean surgical systems having a laser, for example, an excimer laser such as a spot scanning excimer laser. Preferably, these laser systems also include computers to carry out the treatment in a computer-aided manner. Particularly preferably, accessory systems such as eye-tracking systems are also provided, as well as lighting devices for the operation site, i.e., especially for the eye.
The unique data is unique with respect to the operation site. Therefore, it is possible for an operation site to be uniquely distinguished from another operation site on the basis of this unique data.
The first copy of the unique data is a copy of the relevant data content that uniquely identifies the eye. This first copy can be stored in the laser system and is thus available to the laser system in the later course of the operation. This unique data is particularly preferably determined prior to the operation and is then available in the further course of the operation.
The unique data is particularly preferably located in the immediate vicinity of the operation site and/or at the operation site. Therefore, it is particularly preferred for this unique data to be immediately next to the eye or even in the eye. The data here can preferably be additionally attached data or data that is already available directly in the operation site or eye. Thus, for example, it is possible for this unique data to be spatially and temporally bound to the eye in a fixed manner, for example, using a sticker, a color marking, preferably as a bar code, a microchip firmly connected to the eyebrow, etc., or the unique data is data that is already located at the operation site, i.e., fixed parameters which uniquely define this operation site, in particular the eye, such as a fingerprint defines a thumb.
Preferably, the first copy of the unique data is then compared to the unique data before the operation begins, thus performing an identity check. Then, the result of this identity check is preferably passed on to the laser system. The further procedure can then be made dependent on the result of this identity check. Thus, for example, it is possible not to permit the operation at all unless the identity check has been completed successfully. Moreover, it is conceivable to inform the operator of a failed identity check before the operation begins.
According to a preferred exemplary embodiment of the present invention, the unique data includes the patient's name, the patient's first name, the patient's data of birth, patient ID, physician ID, information about the operation site, or a combination of individual pieces or all of this data. Thus, for example, it is possible to generate a character string containing information about the specific eye of a specific patient, thus making this eye unique. However, it is particularly preferred to use information about the operation site itself, in particular, vessel patterns and/or patterns of the iris. For this purpose, it is particularly preferred to use vessel patterns of the fundus of the eye, which are different for each eye, even of the same patient, and which have the most individual characteristics uniquely identifying the eye. The pattern of the iris is particularly preferred as well. These patterns are unique as well as stable in time and space. This information about the eye has the further advantage that many laser systems already contain measuring devices with possibilities to record images as well as image-processing components (topography devices, aberrometers, etc.). Thus, the characteristic or the unique data can be determined and stored with the data set particularly preferably concurrently with the data acquisition. On the side of the operation device, image-processing systems (eye-tracking systems) are frequently used as well. Using these systems, it is now possible for the characteristic or the unique data to be determined from the eye currently present for the operation and to be compared to the characteristic in the data set. If the characteristic is identical, then the unique association is given.
In particularly preferred exemplary embodiments of the present invention, the unique data is embodied as a bar code, microchip, character strings, or a combination of these types of representation. This unique data, which is then preferably arranged in the immediate vicinity of the operation site can, for example, be stuck, drawn, applied, or painted on.
Moreover, the present invention is achieved by a device for identifying an operation site during an operation, particularly preferrably for carrying out one of the methods according to the present invention, containing a laser system having a storage unit with a storage of unique data about the operation site and a laser unit, the unique data being determinable using the laser unit, a first copy of the unique data being storable in the storage unit, and provision being made for a comparator device which allows the first copy and the unique data to be checked for their identity. Using such a device, it is possible both to acquire unique data using a laser unit, such as a bar code laser or an image sensing unit, and to store this unique data in the form of a copy in the storage unit so that it can later be checked with the unique data using a comparator device.
This device guarantees that the obtained data is always uniquely associated with the eye from which it was obtained.
Confusion of names, etc., no longer matter because, primarily, the data is always linked to eye and not to the name. Moreover, these solutions can preferably be used actively or passively.
In the case of passive use, the data set is selected as before using patient names, etc.; immediately thereafter, the laser unit or an identification unit looks for the characteristic or the unique data at the eye and compares it to the data set. In case of discrepancy between the characteristics, operation is not permitted.
In the case of active use, the patient's eye is examined directly using the laser unit or the identification unit, and the matching data set is automatically loaded into the laser. Preferably, this patient data (such as name, etc.) is then also indicated to the physician.
Moreover, it is possible to use the present invention such that it includes attachment of the unique data or of this additional characteristic, or to obtain this unique data directly from the eye itself.
It is particularly preferred to recheck the eye correction state shortly before the operation. In this manner, it is in addition possible to prevent double operations of the same eye.